<table class="s3basicedit wiform">
                       <tbody>
                          <tr>
                             <td colspan="2">
                                <h2 class="s3">Sửa địa điểm</h2>
                                <hr style="margin-top: -2px" class="s3"/>
                             </td>
                          </tr>
                          <tr class="base">
                            <input type="hidden" name="id" value="<?php echo $data->id?>"/>
                            <input type="hidden" name="type" value="edit"/>
                          </tr>
                          <tr class="top">
                             <td class="s3l align-right">ID Địa điểm:</td>
                             <td class="s3w"><?php echo $data->id?></td>
                          </tr>
                          <tr class="top">
                             <td class="s3l align-right">Chọn tỉnh <span style="color: red;">(*)</span>:</td>
                             <td class="s3w">
                                <?php echo $fview->selectOption($province, $data->id_province, 'w99', 'province', 'province');?>
                             </td>
                          </tr>
                          <tr class="top">
                             <td class="s3l align-right">Chọn quận huyện <span style="color: red;">(*)</span>:</td>
                             <td class="s3w" id="district_select">
                                <?php echo $fview->selectOption(@$district ? @$district : array('Vui lòng chọn tỉnh thành phố'), $data->id_district, 'w99', 'district', 'district');?>
                             </td>
                          </tr>
                          <tr class="top">
                             <td class="s3l align-right">Tên cửa hàng <span style="color: red;">(*)</span>:</td>
                             <td class="s3w"><input type="text" value="<?php echo stripslashes($data->name)?>" name="name" id="name" class="w99"/></td>
                          </tr>
                          <tr class="top">
                             <td class="s3l align-right">Địa chỉ <span style="color: red;">(*)</span>:</td>
                             <td class="s3w"><input type="text" value="<?php echo $data->address?>" name="address" id="address" class="w99"/><button id="get-lat-long">GET</button></td>
                          </tr>
                          <tr class="top" id="box-map">
                             <td></td>
                             <td class="s3w" style="position: relative;line-height: normal">
                                <div align="center" id="map" style="width: 350px; height: 200px; position: relative; top: 2%; right: 5px; z-index: 999999; box-shadow: rgb(85, 85, 85) 0px 2px 6px; overflow: hidden; transform: translateZ(0px) translateZ(0px) translateZ(0px) translateZ(0px) translateZ(0px) translateZ(0px); background: rgb(255, 255, 255);"><br/></div>
                                <div class="show_msg" >
                                    Đang tải ...
                                </div>
                                <div class="close-map" >
                                    [ Tắt ]
                                </div>
                             </td>
                          </tr>
                          <tr class="top">
                             <td class="s3l align-right">Lat:</td>
                             <td class="s3w"><input type="text" value="<?php echo $data->lat?>" name="lat" id="lat" class="w99"/></td>
                          </tr>
                          <tr class="top">
                             <td class="s3l align-right">Long:</td>
                             <td class="s3w"><input type="text" value="<?php echo $data->long?>" name="long" id="lng" class="w99"/></td>
                          </tr>
                          <tr class="top">
                             <td class="s3l align-right">Nhóm mạng <span style="color: red;">(*)</span>:</td>
                             <td class="s3w">
                                <?php echo $fview->selectOption($group, $data->group_id, 'w99', 'group', 'group');?>
                             </td>
                          </tr>
                          <tr class="base">
                             <td colspan="2" class="s3actions">
                                <div>
                                   <table style="margin: 0.5ex auto 0.5ex auto" class="lean">
                                      <tbody>
                                         <tr>
                                            <td><input type="submit" id="submit" value="Save"/> <input class="cancelaj" type="reset" value="Cancel"/></td>
                                         </tr>
                                      </tbody>
                                   </table>
                                </div>
                             </td>
                          </tr>
                       </tbody>
                    </table>